| Payment ID | 71186 |
|---|---|
| Date Created | 07/09/24 1:02 pm |
| Created By | Gloria Jimenez |
| Service Request | 70373 |
| Application ID | 69458 |
| Authorization Number | 224050 |
| Applicant Information | |
| Name | Ian Nichols |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170403401 |
| Payment Type | Transportation |
| Type of Service Request | Transportation |
| Payment Details | |
| Payment Amount | $80.00 |
| Receipt Amount | $80.00 |
| Receipt Date | 07/08/2024 |
| Comments | bus passes delivered |
| Receipt | 71186-Nichols.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 07/09/2024 |
